(The Root) — From its initial inception to the official launch, members of the GOP and conservative talking heads have fought the Affordable Care Act. But millions of impoverished Americans and the working poor do not have and cannot afford health insurance coverage. This is especially the case in the 26 states that opted out of the Medicaid expansion. According to the New York Times, those states that have rejected the expansion are home to about half of the country's population, and about 60 percent of the country's uninsured working poor are in those states.
But despite the political rancor in Washington, D.C., there are policy makers, even in red states, who are successfully implementing Obamacare and reaching the invisible poor. One of those states is Kentucky, from which two of the loudest critics of Obamacare — Senate Minority Leader Mitch McConnell and Tea Party spokesman Sen. Rand Paul — hail.
Led by a Democratic governor, Kentucky — a reliably red, Southern state — has chosen to set up the state-based exchange and accept Medicaid expansion, and in so doing, is emerging as the poster child of the New South.
Kentucky is the fifth poorest state in the country — with a 19.4 percent poverty rate and 640,000 Kentuckians without health insurance. One in four children in the bluegrass state live in poverty, and this has disastrous effects on the long-term health of communities and hinders social mobility.
Kentucky's Gov. Steve Beshear told The Root he is committed to providing citizens universal coverage, seeing it as both a moral cause and an economic one.
President Obama has praised Beshear, saying he is "like a man possessed" because of his almost religious commitment to the implementation of the ACA. And despite initial glitches with the federal online health care exchange, Kentucky's version of Obamacare, known as Kynect, is running smoothly.
Gov. Beshear spoke exclusively to The Root about how his state is successfully enrolling Kentucky residents, both urban and rural, into the Medicaid expansion and private exchange. He says that despite stereotypes about his state's demographics, Kentucky is experiencing a progressive 21st-century renaissance.
The Root: Given the high concentration of poverty in Kentucky and given the stark reality that many of them are Republican voters, how have you gone about implementing Obamacare and convincing people to participate?
Steve Beshear: First of all, as governor, I don't have the luxury of spending a lot of time debating ideology. I'm responsible for over 4.3 million people, and I deal with them every day in terms of what affects their lives on a daily basis and how I can improve the quality of those lives while I'm in this office.
In this whole health care debate what is lost is who we're really talking about. I have 640,000 Kentuckians that don't have any health care coverage. And those aren't a group of aliens from some strange planet; these are our friends and neighbors. These are people we go to church with, we shop in the grocery with, we sit in the bleachers on Friday nights and watch our kids play football, soccer and baseball. Some of these folks are members of our family. These are real, everyday people. And they are one bad diagnosis away from bankruptcy.
And when I look at Kentucky's health status, we have some of the worst health statistics in the nation. And we've had those same statistics and same rankings for decades. And while we've made small inroads to make life better for our people, we have been in need of some transformational tool to be able to get out of this ditch. And the Affordable Care Act has given me that tool. And I don't really care if it's a Democrat idea or a Republican idea — if it's a good idea then we ought to grab hold of it and do it.
So far we have signed up over 26,000 people for expanded Medicaid and the qualified health plans, and that doesn't include the 10,000 more people who are in the process of choosing a plan.
This is going to be a game changer. We are going to see a much healthier population here. A much healthier workforce and therefore a more productive society.
TR: How do you see universal health care improving your state's economy?
SB: One of my top priorities as governor has been to stimulate our economy and create jobs for our people. When I came into office in December of 2007, within a month I was hit square in the face with the worst recession of our lifetimes. And I've had to lead this state through that economic disaster, and we've been pretty successful. We have had one of the best growth rates of any states for two to three years now.
But what I have found on the road as I speak to companies and businesses about relocating to Kentucky or expanding their operations in Kentucky, while they are interested in tax incentives, and good roads and transportations and logistics, the top priority of these businesses is a quality, educated, skilled workforce.
And it is obvious that if you have an unhealthy workforce, you're not going to have a very productive workforce. They're going to be off sick a lot, or they're going to be home taking care of their child because they can't afford to take the child to the doctor to get him or her well. If we are successful in improving the long-term health of our people, our families and our children, we are going to have a workforce second to none. We are going to be so much more attractive for businesses to come here and create the jobs we need.
TR: What has been your messaging strategy? How do you convince poor whites in the rural South that Obamacare is not socialism? Or that President Obama isn't giving them health care to kill them?
SB: I know for people in the news media, when they think of Kentucky the first thing that comes to mind may be the faces of our congressional delegation. That is not what Kentucky is about. Kentucky is actually a really progressive place.
This perspective is also a part of our messaging strategy to Kentuckians. We speak to people where they are. We are about helping them better their lives. And we are building the necessary tools to get them there.
I want people to know that despite what members of Kentucky's congressional delegation may say or stand for, that doesn't accurately represent our people. I don't want old clichés that people have heard from the distant past to form their opinions when it comes to this state that I love.
We are a welcoming place. This is a wonderful place to live. There are people of every religion, every race, culture and viewpoint in Kentucky. We are changing, and we welcome that change.
Edward Wyckoff Williams is a contributing editor at The Root. He is a columnist and political analyst, appearing on Al-Jazeera, MSNBC, ABC, CBS Washington and national syndicated radio. Follow him on Twitter and Facebook.
Edward Wyckoff Williams is a contributing editor at The Root. He is a columnist and political analyst, appearing on Al-Jazeera, MSNBC, ABC, CBS Washington and national syndicated radio. Follow him on Twitter and on Facebook.